Coronary artery diseaseImpact of Thrombectomy With EXPort Catheter in Infarct-Related Artery During Primary Percutaneous Coronary Intervention (EXPIRA Trial) on Cardiac Death
Section snippets
Methods
Details of the EXPIRA trial have been previously reported.11 EXPIRA investigated whether thrombus aspiration as adjunctive therapy in PPCI was better than standard PCI in patients with STEMI and angiographic evidence of a large thrombus burden. The trial was a single-center, randomized, open study with blinded assessment of end points.
One hundred seventy-five consecutive patients admitted with STEMI and candidates for PPCI were enrolled at the Policlinico Umberto I, “Sapienza” University of
Results
Baseline clinical and angiographic characteristics were well-balanced between the 2 groups with the exception of hypertension, smoke and cholesterol levels. Procedural angiographic results previous published are also reported11 (Table 1).
Written questionnaires to obtain information on vital status, hospital admissions, and current medical therapy were available for all patients in each group.
No significant differences in current medical therapy were observed between groups at 2-year follow-up (
Discussion
For the first time a very long-term follow-up (>1 year) was assessed in the setting of PPCI treated with adjunctive manual thrombectomy.
The main finding of the present study is that pretreatment with manual thrombectomy during PPCI results in a lower cardiac mortality and a lower incidence of other MACEs at 2-year follow-up than conventional therapy alone.
PPCI with stent implantation and pretreatment with abciximab is currently the preferred revascularization strategy in patients with STEMI.1, 2
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2017, Cardiovascular Revascularization MedicineCitation Excerpt :Thrombectomy during acute MI has shown conflicting results. There is some evidence that manual thrombectomy can reduce infarct size and preserve microvascular integrity as assessed by CMR [62]. On the other hand, a meta-analysis suggested that it may be associated with harm [63].
Manual thrombus aspiration during primary percutaneous coronary intervention: Impact of total ischemic time
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2016, American Journal of Cardiology
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Dr. Sardella and Dr. Mancone contributed equally to this article.